Doctor Steven R. Goldstein MD is a leading abnormal uterine bleeding specialist in New York City who works closely with patients to determine likely causes of abnormal or heavy uterine bleeding. He is considered one of the nation’s top doctors in gynecology and one of the most highly recognized and regarded individuals in the field of painless, non-invasive vaginal probe ultrasounds, which are his first means of diagnosis for abnormal uterine bleeding.
Abnormal uterine bleeding is that which occurs after menopause (called post menopausal bleeding), or heavy vaginal bleeding when compared to your regular periods. There should be no bleeding or spotting between periods, or after sex. If you are menopausal, there should be no bleeding after your cycles have ended.
Many women experience what they perceive as abnormal uterine bleeding at least once in their lives. Women in their 20s and early 30s often have unusual bleeding due to a hormonal imbalance. Abnormal uterine bleeding becomes more common as women near menopause. However, concerns remain about uterine polyps, fibroids and cancers.
Women may experience heavy periods (menorrhagia) or periods that last longer than normal. Read more about heavy periods (menorrhagia).
Here are some of the signs of abnormal uterine bleeding.
If you are experiencing any of the above, a consultation with Abnormal Uterine Bleeding Specialist in NYC, Dr Steven R. Goldstein may be in order.
Abnormal uterine bleeding can be caused by many reasons, ranging from hormonal imbalances to uterine polyps, fibroids, cancer, miscarriage or the onset of menopause.
Uterine polyps, or endometrial polpys, are small, bulb-shaped masses of endometrial tissue. They are often benign and asymptomatic. Polyps can, however, sometimes cause abnormal bleeding and impact fertility. Transvaginal ultrasounds, sometimes with infusion of saline (sonohysterogram), are the most common tools to identify presence of uterine polyps and removal of polyps.
As many as one in five women develop uterine fibroids during their child-bearing years. Fibroids refer to small, benign tumors that develop in a woman’s womb. Common symptoms of uterine fibroids include:
Pelvic exams and transvaginal ultrasounds are often used to identify the presence of fibroids in the uterus however these fibroids are like real estate – location, location, location. Only with transvaginal ultrasounds can we determine the proper location of fibroids. The ones that impact the uterine cavity will have the most effect on bleeding and / or fertility.
A hormonal balance can cause bleeding. If there is too much estrogen or not enough progesterone. This may occur in women approaching menopause or those that are in Perimenopause.
Treatment and management vary based on each patient’s health, medical history, symptoms and future plans, including wanting to become pregnant. If you have been told to have an endometrial biopsy as the first means of diagnosis, then DO NOT. Dr Goldstein uses painless, non-invasive Sonohysterograms as a first means of diagnosis to determine the cause of any abnormal uterine bleeding.
Both you, the patient, and Dr Goldstein will be able to see on a screen the uterus, uterine lining, fallopian tubes ovaries, cervix and more. Clear, precise, high resolution images will be produced and analysed.
Dr. Goldstein is a former Director of Gynecologic Ultrasound at the NYU Langone Medical Center. Dr. Goldstein personally performs all transvaginal ultrasounds and Sonohysterograms so he can see all the high resolution images first hand and can use the equipment to hone in on what he needs to see live. He does not rely on the report of technician since many of the images rely on the skill of the operator. Dr. Goldstein is a highly skilled operator, thus he performs all procedures personally.
Dr. Goldstein developed a catheter to put a tablespoon of sterile saline into the uterus, so women with abnormal uterine bleeding can avoid unnecessary biopsies, dilations and curettage procedures, and hysterectomies.
In this video Dr. Goldstein explains why the use of painless, non-invasive Sonohysterograms are so effective in diagnosing gynecologic conditions, including abnormal uterine bleeding.
Dr. Goldstein is the recipient of the 2018 Joseph H. Holmes Clinical Pioneer Award from the American Institute of Ultrasound in Medicine (AIUM). This is in recognition of Dr Goldstein’s distinguished career in ultrasound in medicine, and making outstanding contributions to the growth and development of medical ultrasound.
Dr. Goldstein servesdas the Director for Gynecologic Ultrasound, Department of Obstetrics and Gynecology at New York University Medical Center. He has led grants and research relating to abnormal bleeding and gynecologic ultrasounds. Serving on the editorial board more than six scientific journals, he regularly contributes to advancements in the field.
Dr. Goldstein begins by discussing medical histories and using non-invasive procedures, such as ultrasounds, sonohysterography or saline-infused solution sonohysterography to diagnose the problem and discuss treatment options. He often provides consults with women seeking second opinions and non-invasive treatment options over gynecologic surgery.
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